Association of Condylar Bone Quality with TMJ Osteoarthritis
Association of Condylar Bone Quality with TMJ Osteoarthritis
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DOI：
10.1177/0022034517707515
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发表时间：
2017-07-01
影响因子：
7.6
通讯作者：
Kwak, J. H.
中科院分区：
文献类型：
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作者：
Shi, J.;Lee, S.;Kwak, J. H.
颞下颌关节骨关节炎（TMJOA）的病因和治疗方法至今仍不清楚.基于临床观察，我们假设髁状突骨质量低与TMJOA显著相关，并在一项人类患者的横断面研究中探讨了这种相关性。本研究共纳入254例绝经后女性受试者。锥形束计算机断层扫描（CBCT）的影像学结果和临床症状用于将每个TMJ数据样本分类为健康对照（n = 124）或TMJOA（n = 130）。测量髁突骨矿物质密度（BMD）（计算机断层扫描Hounsfield单位[CT HU]）和骨体积分数（BV/TV），并在多水平logistic回归分析中建模为健康对照与TMJOA状态的预测因子。CT HU（校正比值比[AOR] = 0.9989，四分位数比值比[IOR] = 0.4206）和BV/TV（AOR= 0.8096，IOR = 0.1769）与TMJOA呈负相关（分别为P = 0.049，0.011）。为了评估CT HU和BV/TV用于识别TMJOA的诊断性能，绘制了受试者工作特征（ROC）曲线。BV/TV单独给药的估计曲线下面积（AUC）为0.6622，CT HU单独给药的估计曲线下面积为0.6074，CT HU和BV/TV联合给药的估计曲线下面积为0.7136。合并CT HU和BV/TV的模型具有比单独使用BV/TV（P = 0.038）或单独使用HU（P = 0.021）的模型显著更高的AUC。总之，我们发现低髁状突骨质量与TMJOA的发展显著相关，髁状突CT HU和BV/TV可以一起用作TMJOA的潜在诊断工具。因此，对髁状突进行仔细的临床评价，结合适当的影像学解释，对于TMJOA的早期检测至关重要。
The etiology and treatment of temporomandibular joint (TMJ) osteoarthritis (TMJOA) remain complex and unclear. Based on clinical observations, we hypothesized that low condylar bone quality is significantly correlated with TMJOA and explored this association in a cross-sectional study with human patients. A total of 254 postmenopausal female participants were included in this study. Radiographic findings from cone beam computed tomography (CBCT) and clinical symptoms were used to classify each TMJ data sample as healthy control (n = 124) or TMJOA (n = 130). Condylar bone mineral density (BMD) (computed tomography Hounsfield unit [CT HU]) and bone volume fraction (BV/TV) were measured and modeled as predictors of healthy control versus TMJOA status in multilevel logistic regression analyses. Both CT HU (adjusted odds ratio [AOR] = 0.9989, interquartile odds ratio [IOR] = 0.4206) and BV/TV (AOR= 0.8096, IOR = 0.1769) were negatively associated with TMJOA (P = 0.049, 0.011, respectively). To assess the diagnostic performance of CT HU and BV/TV for identification of TMJOA, receiver operating characteristic (ROC) curves were plotted. The estimated areas under the curve (AUC) were 0.6622 for BV/TV alone, 0.6074 for CT HU alone, and 0.7136 for CT HU and BV/TV together. The model incorporating CT HU and BV/TV together had a significantly higher AUC than the models using BV/TV alone (P = 0.038) or HU alone (P = 0.021). In conclusion, we found that low condylar bone quality was significantly correlated with TMJOA development and that condylar CT HU and BV/TV can be used together as a potential diagnostic tool for TMJOA. Careful clinical evaluation of the condyle coupled with appropriate radiographic interpretation would thus be critical for the early detection of TMJOA.